14 February 2011

Lyndal Trevena

FOR some time now, Australia has struggled to define what men’s health actually means in general practice.

But there is one recurring theme when discussing the challenge of men’s health — communication.

In our recent paper in Family Practicewe explored ways in which Malaysian GPs initiate health check-ups with their male patients.

Our study showed that the GPs’ decision making was largely driven by a combination of factors related to clinical importance but moderated substantially by the doctor’s perception of how “receptive” the patient was to discussing those issues at hand.

The GPs weighed up their chance of success in negotiating the topic with their male patients and adjusted their consultation accordingly.

Australian GPs may well share these struggles with their Malaysian counterparts.

The first National Male Health Policy — Building on the Strengths of Australian Males — was published in 2010. Development of the new Australian policy — quite rightly — started by consulting with Australian men about their health needs and perceptions of health.

The Australian Government has also formed an active partnership with the RACGP to implement the M5 project, which encourages men to take 5 minutes to think about their health and encourages them to visit their GP.

However, our study raises the question of how these initiatives can best be implemented at the clinical interface in general practice, where negotiating a discussion about preventive health with male patients may provide unique challenges within a busy day of clinical practice.

This is particularly so for resource-stretched rural and regional general practice where men’s health remains poorer than their urban counterparts.

The RACGP’s National Curriculum includes competencies in men’s health and it will be interesting to see the downstream effects of this statement in clinical practice.

We don’t really have similar data on how Australian GPs initiate discussions about preventive health with their male patients but the Malaysian experience is certainly “food for thought”.

It can do us no harm to reflect on these findings and be more aware of our own challenges in negotiating preventive health issues with men.

If we are truly honest with ourselves, making assumptions about the “receptivity” of our male patients regarding preventive health may be a trap we all fall into from time to time.

If indeed such assumption does exist, some measures are needed to facilitate communication with men so GPs can avoid erroneous decision making.

Associate Professor Lyndal Trevena is associate dean in the School of Public Health at the University of Sydney and a practising GP, and Dr Seng Fah Tong is a senior lecturer in the Department of Family Medicine at the National University of Malaysia.